摘要
目的探讨高场强磁共振的磁敏感加权成像(SWI)在新生儿缺氧缺血性脑病(HIE)早期诊断中的应用价值。方法选取自2017年6月至2018年7月哈励逊国际和平医院新生儿科确诊的90例HIE患儿为研究对象,根据患儿病情程度分为轻度组(n=51)、中度组(n=27)、重度组(n=12)。采用高场强磁共振3.0T扫描仪对患儿头颅进行常规MRI及SWI序列扫描。比较常规MRI序列与SWI序列对HIE患儿的检出率,同时,观察常规MRI序列与SWI序列对HIE患儿出血灶及静脉扩张的检出率。结果不同临床分度患儿的检查时日龄、胎龄及出生体质量比较,差异均有统计学意义(P<0.05)。90例新生儿HIE早期诊断结果中,常规MRI序列的检出率为87.8%(79/90),SWI的检出率为92.2%(83/90),差异无统计学意义(P>0.05)。不同临床分度,常规MRI序列影像与SWI检出的轻度、中重度患儿比例比较,差异均无统计学意义(P>0.05)。SWI在轻度、中度HIE患儿中的出血灶及静脉扩张检出率均明显低于重度HIE患儿;SWI在轻度HIE患儿中的出血灶及静脉扩张检出率均明显低于中度HIE患儿,差异均有统计学意义(P<0.05)。不同HIE分度患儿,SWI对出血灶及静脉扩张检出率均高于常规MRI序列,差异均有统计学意义(P<0.05)。结论高场强磁共振的SWI对新生儿颅内出血具有高度敏感性,可应用于新生儿HIE的早期诊断,为合理治疗提供客观依据。
Objective To investigate the value of magnetic sensitive weighted imaging(SWI)in the early diagnosis of neonatal hypoxic ischemic encephalopathy(HIE).Methods A retrospective study was performed on 90 cases of children with HIE who were admitted from June 2017 to July 2018.The children were divided into the mild group(n=51),moderate group(n=27)and severe group(n=12)according to progression of disease.The head of the children was scanned with routine MRI and susceptibility sequence using a high field intensity magnetic resonance 3.0 T scanner.The detection rates of HIE children with conventional MRI sequence and susceptibility sequence were compared.Meanwhile,the detection rates of hemorrhagic foci and venous dilation in HIE children with conventional MRI sequence and susceptibility sequence were observed.Results There were statistically significant differences(P<0.05)in the age of examination,gestational age and birth body mass of children with different clinical grades.Among the early diagnosis results of HIE in 90 neonatal patients,the detection rate of routine MRI sequence was 87.8%(79/90),and the detection rate of susceptibility was 92.2%(83/90),with no statistically significant difference(P>0.05).With different clinical grades,there was no statistically significant difference in the proportion of mild,moderate and severe children detected by routine MRI sequence images and susceptibility(P>0.05).The detection rate of SWI and venous dilation in mild and moderate HIE children was significantly lower than that in severe HIE children.The detection rate of SWI and venous dilation in children with mild HIE was significantly lower than that in children with moderate HIE(P<0.05).In children with different HIE grades,the susceptibility to hemorrhagic foci and venous dilation was higher than that of conventional MRI sequences(P<0.05).Conclusion The susceptibility of high field intensity MRI to neonatal intracranial hemorrhage is highly sensitive,which can be applied to the early diagnosis of neonatal HIE and provide ob
作者
张钊
杜乃熠
刘兵
赵树军
康志雷
ZHANG Zhao;DU Nai-yi;LIU Bing;ZHAO Shu-jun;KANG Zhi-lei(Department of MRI,Harrison International Peace Hospital,Hengshui 053000,China)
出处
《创伤与急危重病医学》
2019年第3期152-155,共4页
Trauma and Critical Care Medicine
基金
河北省医学科学研究指令性课题(ZL20140001)
关键词
高场强磁共振
磁敏感加权成像
新生儿
缺氧缺血性脑病
早期诊断
High field magnetic resonance
Susceptibility weighted imaging
Neonatal
Hypoxic ischemic encephalopathy
Early diagnosis
